Overview of Radiotherapy for Glioma The most reliable means of glioma treatment at present is comprehensive treatment, and comprehensive treatment for glioma mainly refers to the three main means of surgery, radiation therapy, and chemotherapy. Radiotherapy is a treatment method that gives uniform and accurate irradiation to certain tumor tissues with a small dose to the surrounding normal tissues. Radical radiotherapy is the main task of glioma radiotherapy. At present, although we have made great progress in the field of basic research on glioma and have also had a hundred years of clinical treatment history, the total treatment effect, especially for malignant glioma, is still unsatisfactory. The combination of surgery, radiotherapy, and chemotherapy remains the only option for glioma. Problems to be solved in radiotherapy for glioma The therapeutic role of radiotherapy as one of the indispensable treatments for glioma has been recognized for a long time. However, there are still many problems that need to be further researched regarding the radiotherapy of glioma. For example: 1, the understanding of subclinical lesions and planned target zone (PTV); 2, strengthening the effect of radiation therapy on tumors from the physical point of view, increasing the irradiation amount of the target zone and decreasing the irradiation amount of normal brain tissues; 3, the application of radio-sensitizing agents; 4, the combined application of radiation therapy, chemotherapy and gene therapy; 5, the prevention of radioactive injury and the study of radioactive protective agents; 6, the exploration of high-LET rays and heavy-particle therapy; and so on. Exploration and so on. The breakthrough of these problems can bring the fundamental change of the effect of glioma radiotherapy. The mechanism of radiation therapy for glioma is mainly to use the penetrating property of radiation and the property of ionizing biological cells. Commonly used in radiotherapy are x-rays and gamma rays, the former is produced by deep X-ray machine or medical electronic gas pedal, and the latter is the rays released by radionuclides in the process of decay. Such as Co-60 therapy machine, γ-knife, etc. X-ray (γ-ray) and other high-energy electron beams and other ionizing radiation into human tissues by interacting with the atoms in human tissues and transferring part or all of the energy of the ionizing radiation, with biological activity of human tissues to absorb ionizing radiation energy will produce a series of abnormal and complex physical, chemical and biological changes, and ultimately lead to biological damage to tissues, i.e., biological effect. The magnitude of the biological effect is proportional to the energy of ionizing radiation absorbed in the tissue. Most patients with gliomas require surgery first, with total or partial resection followed by radiation therapy. Surgery is conducive to the development of radiotherapy plan: 1, clear histopathological properties and changes in molecular pathological indexes are conducive to the development of radiotherapy treatment plan; 2, tumor cell volume reduction, surgical resection of tumor cells that are not sensitive to radiation therapy, reduce the volume of the tumor, reduce the tumor occupying effect, alleviate the clinical symptoms such as cranial hypertension, in order to facilitate the smooth progress of radiotherapy; 3, the reduction of the tumor volume at the same time may also shrink the Irradiation volume, enhance the effect of radiation therapy, reduce the damage, generally speaking, the tumor center blood supply is poor, more oxygen-depleted cells, the tumor is resistant to radiation, as far as possible, total resection of the tumor is the simplest and most direct way to increase the effect of radiotherapy; 4, for the functional area of gliomas, it is difficult to cut the whole tumor with surgery can be inserted into the internal irradiation of radioactive particles, and can be supplemented with external irradiation after surgery, which is one of the modes of radiotherapy for gliomas. For gliomatosis or diffuse growth of glioma, biopsy or internal decompression surgery should be done to clarify the pathological type, especially through molecular pathological analysis to understand the sensitivity of the tumor to radiotherapy/chemotherapy, to select chemotherapeutic drugs, and to formulate a comprehensive treatment plan. It should be noted that for gliomas suspected in important functional areas such as thalamus and brainstem, blind radiotherapy/chemotherapy may lead to misdiagnosis and mismanagement, which should be treated with great caution. Experimental radiotherapy for gliomas without a clear diagnosis should be prohibited.